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|Title:||Measurement of cardiac output during exercise in healthy, trained humans using lithium dilution and pulse contour analysis|
|Citation:||Physiological Measurement, 2012; 33(10):1691-1701|
|Publisher:||IOP Publishing Ltd|
|Adrian D Elliott, Justin Skowno, Mahesh Prabhu and Les Ansley|
|Abstract:||The aim of this study was to evaluate the use of pulse contour analysis calibrated with lithium dilution in a single device (LiDCO™) for measurement of cardiac output (Q-dot) during exercise in healthy volunteers. We sought to; (a) compare pulse contour analysis (PulseCO) and lithium indicator dilution (LiDCO) for the measurement of Q-dot during exercise, and (b) assess the requirement for recalibration of PulseCO with LiDCO during exercise. Ten trained males performed multi-stage cycling exercise at intensities below and above ventilatory threshold before constant load maximal exercise to exhaustion. Uncalibrated PulseCO Q-dot (Q-dot raw) was compared to that calibrated with lithium dilution at baseline (Q-dot baseline), during submaximal exercise below (Q-dot low) and above (Q-dot high) ventilatory threshold, and at each exercise stage individually (Q-dot exercise). There was a significant difference between Q-dot baseline and all other calibration methods during exercise, but not at rest. No significant differences were observed between other methods. Closest agreement with Q-dot exercise was observed for Q-dot high (bias ± limits of agreement: 4.8 ± 30.0%). The difference between Q-dot exercise and both Q-dot low and Q-dot raw was characterized by low bias (4–7%) and wide limits of agreement (>±40%). Calibration of pulse contour analysis with lithium dilution prior to exercise leads to a systematic overestimation of exercising cardiac output. A single calibration performed during exercise above the ventilatory threshold provided acceptable limits of agreement with an approach incorporating multiple calibrations throughout exercise. Pulse contour analysis may be used for Q-dot measurement during exercise providing the system is calibrated during exercise.|
|Keywords:||indicator dilution; stroke volume; haemodynamics; arterial pressure waveform|
|Rights:||© 2012 Institute of Physics and Engineering in Medicine|
|Appears in Collections:||Physiology publications|
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